New data say advanced-practice clinicians provided about a third of abortions in the formal US medical system last year. In states with physician-only restrictions, the law still keeps them out of that role. Apparently a medical credential acquires its full powers only when paired with the correct highway welcome sign.

The Guttmacher Institute, which researches and advocates for abortion access, puts the 2025 figure above 360,000. These are trained professionals, including nurse practitioners, physician associates and midwives—not people selected because they looked confident carrying a clipboard. The supposedly radical alternative to physician-only rules is an enormous part of the care already being delivered.

Twenty-five states and Washington, DC, authorize at least some of these clinicians. The permitted work varies, often covering medication or early aspiration procedures. Nobody’s credential is a universal permission slip for every medical task. Actual training matters. Which makes it peculiar to treat a line on a map as though it has completed a residency.

Welcome to the state. Your clinical knowledge has now been reassessed by a sign beside a gas station.

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The American College of Obstetricians and Gynecologists recommends allowing advanced-practice clinicians to provide abortions and says physician-only restrictions lack a scientific basis. That puts the professional organization at odds with the political instinct to protect medical standards by overruling medical expertise.

Imagine hiring an orchestra, learning that the musicians know how to play, and then asking the zoning committee whether the violas are qualified. We have a respected local man who once owned a radio. He has concerns.

The legal disputes aren’t finished. A Missouri judge upheld its physician-only rule, citing training differences among abortion types. Arizona’s challenge remains pending. Those questions deserve attention to the actual procedure and actual qualification, not a mystical belief that competence evaporates at a border crossing.

The new count excludes self-managed abortions and care outside the formal system. Even within that narrower measure, these professionals did roughly a third of the work.

Perhaps the next legislative hearing could admit that the mysterious substitute for qualified medical care is, in this case, qualified medical care. The welcome sign can remain available for second opinions.